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CLCT COMPILED QUIZZES RATED A+
The International Code - ANSWER -addresses improper
marketing practices ex hospital giving out discharge packages with formula
Milking Stool- 3 legs - ANSWER -Protect, promote & Support-
want all to be equal
Levels of evidence based pyramid - ANSWER -top - bottom:
1.Metanalysis &systemic reviews 2. Single randomized controlled studies 3. Cohort studies 4. Case Controlled Studies 5. Case Studies
When is greatest risk of stopping breastfeeding? - ANSWER -3-
days (after going home from hospital)
Top reasons people stop breastfeeding - ANSWER -baby won't
latch, breast pain/soreness, work/school
Russ Labs Marketing Survey - ANSWER -survey 1965-
formula company tracking breastfeeding goals
Races in Order most likely to BF - ANSWER -spanish speaking-
hispanic, white, hispanic, black
Global Strategy for Infant and young feeding - ANSWER -WHO
and UNICEF developed this global strategy to focus world attention on impact of feeding practices on the nutritional status,
growth, development and health and thus the survival of infants and young children.
World Breastfeeding trends innitive - ANSWER -help track how
they are doing on global outcomes
innocenti ospitale -florence - ANSWER -BF orphan babies
increased rate of survival-today UNICEF child resource nutrition center
path of messages to make milk - ANSWER -message to breast-to
nervous system -to brain- to hormones to travel to breast- then to blood stream
what cells make milk - ANSWER -alveolar cells
alveolar cells are what?
what are they surrounded by - ANSWER -layer of cells with milk
inside, surrounded by myoepitheal cells
Myoepitheal cells will contract when what hits them - ANSWER -
oxytocin
Are the ducts in breast evenly spaced? - ANSWER -No varies
woman to woman
How many nipple pores each breast? - ANSWER -3-
sites will start to ______ _______. - ANSWER -low, not, start
shutting down
What is in receptor site during pregnancy? - ANSWER -
Progesterone When placenta leaves the body, the body responds by pushing
______ out of the receptor sites? - ANSWER -progesterone
When placenta is pushed out of body, progesterone leaves the receptor sites and they are open briefly, what goes inside to set
site for lactation? - ANSWER -Prolactin
If prolactin is not set during first few hours after birth- -
ANSWER -there will be fewer sites and cause issues with milk
supply Ongoing milk supply is associated with suckling within first ______
hours after birth - ANSWER -
For mothers with preemies initation of milk expression before _______ hours resulted in significantly more milk by day 7 -
ANSWER -one
What hormone T3, T4, T5 - ANSWER -Oxytocin
When oxytocin hits myoepitheal cells what happens? -
ANSWER -They start retracting
Oxytocin helps ducts to ______ in size and lumen to get ______ -
ANSWER -increase, smaller
What triggers oxytocin? - ANSWER -1. conditioned response
(repeated stimuli over time) 2. Nipple Stretching (happens with proper latch- oxytocin levels goes up and down with suck and swallow)
- baby hand massage (has to do with T3 and T5) each hand movement releases oxytocin
Where is oxytocin and prolactin excreted? - ANSWER -pituitary
gland
______ is excreted from posterior pituitary? - ANSWER -Oxytocin
______ is excreted from anterior pituitary? - ANSWER -Prolactin
Prolactin is produced mainly by nipple ______, by presence of baby
stimulation T ____ & T____ - ANSWER -stimulation, 4 and 5
________ hormone is affected by stress and ______ hormone is not
affected by stress - ANSWER -oxytocin (extreme situation, will
stop flowing), prolactin
Milk is species ______. - ANSWER -Specific
As prolactin goes into receptor sites and makes milk the ______
disappear - ANSWER -spaces
Preterm milk appears to have higher ______, _______ and _____
than term milk (sga, lga does not matter) - ANSWER -protein, fat
and electrolytes Breastmilk changes after 6 months it is more _____, fat _____ and
after a year fat _________ and energy content ______ - ANSWER -
dense, increases, increases, increases
does it matter if it is foremilk, hindmilk - ANSWER -no think of
kalahari desert nurse for 2.5 min at a time
Breastmilk composition ______ during a feed. - ANSWER -
changes when doing before and after breastfeeding weight even if volume
is low, fat content can be _______. - ANSWER -high
the degree of breast ______ influences the amount of milk available and breast storage _____ influences the amount of fat
transfered. - ANSWER -emptying, capacity
longer times in between feed leds to ______ fat concentration -
ANSWER -lower
faster milk removal is associated with _____fat content and longer feeding time is associated with ______ levels of milk transfer and
_____ fat - ANSWER -higher, lower, lower
Does one breast or two breast feed matter? - ANSWER -doesnt
matter just do whatever seems better for baby Do male babies haver higher energy content in milk? -
ANSWER -yes
Can men produce milk? What situation?
Men can never produce? - ANSWER -yes, tumor/drugs,
colustrum
Formula fed babies have ______ extra in the gut - ANSWER -iron
Presence of bifidus factor in milk promotes presence of _________ ________ maintaing. a ____ PH and crowd out pathogenic _______. -
ANSWER -lactobicillus bifidus, low, organisms
Formula fed babies have increased number of species and over
representation of - ANSWER -C-diff
BF babies have antibiodies that bind to _______ in GI tract that keep them from getting absorbed. This helps to protect from NEC
IN preemies. - ANSWER -microbes
AAP says should be at least _____ formal evaluation and
documentation of trained caregiver per shift - ANSWER -one
Does it make a difference if mother is undernourished for breastfeeding? In refugee camp what is safer breastfeeding or
formula? - ANSWER -No, breastfeeding - no access to clean
water, heating sterilization
Breast size affects milk production? T/F - ANSWER -False
Does increasing fluid increase milk production T/F? - ANSWER -
False
Too much exercise can impact milk production? T/F - ANSWER -
False
Does stress impact milk production? T/F - ANSWER -False
although stress can change behavior When infant suckles at breast there is outpoor of ___ different GI
hormones? - ANSWER -
How many extra calories per day are required when
breastfeeding? - ANSWER -
secretory activation is also called - ANSWER -lactogensis stage 2
the absence of the placenta leads to lactogensis stage, then drop
in progesterone leads to lactogensis stage ___ - ANSWER -2, 3
In nipple engorgement breast is _____, body temp ____, brest can
be hot and ____ - ANSWER -hard, increased , shiny
Engorgement typically happens days -, women with c-
sections may experience engorgement ______ - ANSWER -3-5,
laet With engorgement the more time spent breastfeeding in the first 48 hours will result in less _____, it pressure is not resolved it will
have a ____ impact on breast milk supply. - ANSWER -
engorgement, negative
Engorgement can be natures _____ - ANSWER -dry up method
Inbetween milk making cell systems there is a capillary network delivering nutrients for making milk, if those are crushed nutrient and hormones cannot go where they need to go. What can crush
these and cause problems? - ANSWER -Engorgement
Will pumping help engorgement - ANSWER -No can bust
capillaries and cause bleeding
How to help with engorgement? - ANSWER -Bucket warm water-
immerse breast and within seconds milk will come out, dont want to let all milk into bucket just get some out until plyable and softer, then feed rest to baby
pressure, anemia, fatigue, profound hair loss, dull hair. Can have symptoms partially or fully resolved. Maternal obesity/overweight can delay lactogenis ___ -
ANSWER -
PCOS excess insulin increases production of _____, higher androgens cause acne, excessive hair growth, wt gain and problems with ovulation and _______, possible treatment with -
ANSWER -androgens, lactation, metformin
Drug that cause milk delay? - ANSWER -peeudoephedrine (think
pseudofed), corticosteriods, betamethason (giving to women who will deliver before 24 weeks) if given 3-9 days before delivery can delay lactogensis 2 Mothers who smoke have lower _____ levels if smoked within 12
hrs. - ANSWER -prolactin
Are nicotine patches safe during BF - ANSWER -refer to
healthcare provider Cadmimum is a heavy metal found in _____ and _____ -
ANSWER -cigarettes and formula
What types of formulas have more cadmimum? - ANSWER -Soy
based
22% of all SIDs contributed deaths can be contributed to -
ANSWER -maternal smoking during pregnancy
Are electronic cigarettes safe in pregnancy? - ANSWER -tested
by FDA some contain nicotine and carcinogens, nicotrine transfer appears minimal
Cannabis and Breastfeeding? - ANSWER -passive exposure is a
concern, no safe threshold, lack of studies and high fat solubility makes cannabis difficult to analyaze in breast milk, opinions vary THC is still measurable in EBM ____ days after maternal marijuana
use - ANSWER -
Pacifiers increase risk for ______ and _____ - ANSWER -diarrhea
and ear infections
Pacifiers for preemies? - ANSWER -May have earlier hospital
discharge, tube fed may gain weight faster, improve physiologic and behavioral responses and reduce the time to oral feeds, will not affect breastfeeding for preemies Babies that recieve additional water are at risk for? And this can
cause - ANSWER -Water intoxication- can cause seizures, stroke,
death Early cessation/negative experience of breastfeeding has a
increased risk of postpartum _______ - ANSWER -depression
How to teach to receiver of knowledge? - ANSWER -only show
right way and have them do return demo
Subjective Knowers? - ANSWER -knowing is personal and based
on inuition or thought, inner voice guides them , distrust male figure, find female support groups helpful, trust woman with similar experiences ex: Cher
How to teach subjective knowers? - ANSWER -create time for
them to talk about themselves and what they know about BF, offer help with possible misconceptions
Procedural Knowing? - ANSWER -position in which techniques for
acquiring, validating and evaluating knowledge claims are developed and honored, invested in learning and takin in new info, want diff point of view
How to teach procedural knowers? - ANSWER -Limit personal
stories, understand the option change is part of the process
Constructed Knowing - ANSWER -truth is contextual, knowledge
is tentative, avoid compartments, they want to be same person no matter who they are with, empathetic
Hierarchy of Infant feeding choices? - ANSWER -1. baby at
mothers breast
- Mother own expressed milk
- cow milk formula
- soy formula
No one flange size for each mom- too tight if nipple is rubbing
against______ - ANSWER -tunnel
milk hand expression has a higher ____ content then pumped with
electric pumped and is the _____way to collect milk - ANSWER -
fat, cleanest
how to hand express - ANSWER -push back and squeeze gently
thawed milk is good at room temp for? - ANSWER -1-2 hrs
_____ and its spores has been found in infant formula. -
ANSWER -clostridia
WHO and CDC recommend mixing water at what temp with
powder formula? - ANSWER -70 degrees
Other issues associated with formula fed babies is? - ANSWER -
Reflux (cow milk allergy), reflux, colic, anaphylaxis
LCPUFAs - ANSWER -do not lead to better outcomes
Complication of improper use of almond drink in first year? -
ANSWER -Scurvy
Can a mom breastfeed while using illicit drugs? - ANSWER -No
unless on methadone program
What medications can a mom not breastfeed? - ANSWER -
chemo drugs, rheumatoid arthritis, check book, undergoing radiopharmaceuticals
What is a example of loaded language? - ANSWER -you have a
good baby Late preterm babies are what age? What is our concern about
them? - ANSWER -34-37 weeks pretend to be swallowing go
home and tank
How should a counseling session go? - ANSWER -Listen and
gather information, use questions that cant be ANSWER ed with
a single word, verify what youve heard, offer individualized information, work together and form a plan, fine tune plan and ask what they are going to be doing when leaving, make sure they understand, listen and help with referrals, document Women with history of what are at higher risk for post partum
disorder - ANSWER -premenstrual syndrome and dysphoric
disorder When discussing things postpartum should you give a ton of
information? - ANSWER -No recall is less during post partum
tiredness, limit discussion keep it client centered, educate with truth, validate confidence and counter negativity Babies born during what time of the day are more likely to be
supplemented? - ANSWER -the night and early morning
Pitocin decreases what needed for breastfeeding? Risk factors?
Apgar, NICU? - ANSWER -Oxytocin, lower apgar and increased
nicu risk
What to do for clogs? - ANSWER -Find out cause if recurring,
massage (side of hand) warmth, double nursing (start on the side of the clog, go to the other breast go back to clog)
when to contact health care provider about clog? - ANSWER -
Does not move 24-48 hours or parent develops systemic issues- achey, fever, flu like may need antibiotics
What is a bleb? - ANSWER -clog on nipple tip, look like milk
blisters, one duct opening covered, stabbing pin point pain, may exit like clog, may need to be lanced
common mastitis - ANSWER -breast inflammation, infective or
non-infective, milk making cells squeeze out of normal compartment and body reacts like invader
What can cause mastitis? - ANSWER -blocked ducts from
engorgement, hurried feeding, use of nipple shield, attachment difficulties, tight bra, use of breast shield
